1 Maternity information Expressing your milk for your unwell or premature baby This information leaflet may be helpful if your baby has arrived early or has been admitted to Buscot Ward and you have planned to breastfeed. This is still possible even though you cannot put your baby to the breast yet. It is very important that you start Expressing your milk very soon after birth (ideally within 6 hours) in order to stimulate and then maintain your milk supply until your baby is able to suckle. 1. Begin Expressing as soon as you feel well enough, (ideally by 6 hours). 2. Continue to remove colostrum regularly by Expressing 8-10 times in 24 hours (once at night). At first by hand and then following advice by pump. 3. Ensure all the colostrum collected is stored in an appropriate container or syringe, labelled with your name and the date and given to the neonatal unit staff who will store it until your Being separated from your baby is an baby is ready to feed.
2 Extremely distressing/worrying time for you 4. Ensure you have a photograph or and it can be a great comfort to know by something that smells of the baby sending your breast milk to the neonatal unit when you express. as soon as you are able will contribute to 5. Ask for help. your baby 's progress and health. 6. Read the following information, when you feel well enough. Overleaf you will find detailed information on how to establish your milk supply by Expressing but immediately the key is to: Expressing milk for your premature baby , March 2015 Page 1 of 6. Maternity information If your baby is born early, the first milk you your use on each of the postnatal wards, produce (colostrum) has the perfect and several available on Buscot Ward. composition to satisfy a pre-term infant, and The staff there will show you how to the composition will change to match your operate them. There are four mobile baby 's needs as he or she grows. If you pumps available on Buscot and these have not decided whether to breastfeed, can be used by your baby 's cot side or in Expressing milk for a short time is of the Expressing rooms.
3 Double pumping immense benefit to your baby and you can is recommended as it is very effective decide later whether to breastfeed your and saves time. baby for longer. The first milk is of particular Hand pumps can be kept at the bedside for benefit in providing your baby with your individual use, but can be tiring to use antibodies for protection from infection. and are not as effective at milk removal as If your baby is born before 32 weeks, your the large electric pumps. Ask the staff to set breasts will not yet be fully developed to up a sterilising tank and show you how the produce milk . Early, frequent Expressing will pump is put together, if you choose this help you achieve this and will help with your method. Some mothers choose to buy their long-term supply. own handheld pump to use at home. When should I start to express? How do I express milk for my baby ? You should try to express as soon as o As unwell or premature babies are very possible after birth (ideally within 6 hours) vulnerable to infection, good hygiene is as colostrum is higher in antibodies in the important.
4 Always wash your hands first 24 hours after birth. thoroughly in hot soapy water before starting to express and then sterilise any How should I express? equipment that comes into contact with your milk . You do not have to wash your You can express by hand or by using a breasts each time before you express; a hand-held or electric breast pump. daily bath or shower is sufficient. o Before starting to express, by whatever Which method is recommended if my method you choose, make yourself baby is premature , very small or comfortable, try to relax and focus on unwell ? your baby . 1. Hand Expressing is useful in the first 48 o Make sure you have a drink with you hours when you will only produce small when you sit down. amounts of colostrum, but is difficult to o Applying warm flannels to your breasts maintain in the long-term. Please ask to and gentle breast massage will be shown how to do this. encourage the milk to flow. You can 2. Electric pumps have been shown to be massage your breasts with the heel' of the most effective method for long-term your hand, or by making a fist and gently Expressing .
5 There is one available for moving around the breast to stimulate Expressing milk for your unwell or premature baby , March 2015 Page 2 of 6. Maternity information your hormones. Try not to dig in or apply thumb on 12, then move to 6, then 9 and too much pressure as you massage the so on. breast because this may cause damage 7. When the flow slows down, change to to the tissue. Massage should be the other breast. comfortable and nice. 8. Keep changing breasts until the flow o If you are Expressing on Buscot, the subsides completely. pumps are mobile so please feel free to 9. If there are no signs of milk , move your take a pump and use it by your baby 's finger either nearer or further away from cot side. the nipple until you find the right spot. o If your baby is not with you when you express it may help to have a photo of Using a pump to express milk your baby , a garment which smells of your baby , and/or relaxing music on your Before starting to pump, make sure the IPod, or to get someone to massage nipple is central to the funnel and keep it your back in order to help you relax.
6 Close enough to maintain the vacuum. Lean slightly forward so that the milk flows o Ask for help to hand-express or to downwards into the storage container. assemble both the hand and electric Check the funnel is the right size for your pumps until you feel happy to do this nipples. If the funnel is too large and there yourself. There are diagrams on the wall will not be the best vacuum, too small and it in the ward nurseries for your reference. will rub and make you sore. Hand expression: Hand pump: You will need to be shown how to use this Aim for a rate of about 1 to 2 pumps' a method so please ask. second. 1. Wash hands thoroughly. 2. Have a clean sterilised cup to use before you start. Electric pump: 3. Start by gently massaging the breast. Start at a low suction level and gradually increase this, the suction level needs to be 4. Make a C' shape with your finger and effective, but not uncomfortable. It is thumb and place thumb above and possible to cause damage to the delicate fingers below the nipple.
7 Breast tissue if the level is too high. We will 5. Feel back from your nipple until the help you to understand how to set the tissue texture changes and squeeze suction level safely. Do not try to remove finger and thumb together pressing the the collection funnel while the pump is tissue between. running. 6. Build up a rhythm. Continue to gently Each pumping episode can last between 20. squeeze in a rhythmic manner until the to 30 minutes. It is better to move from one flow stops and then move to another part breast to the other as the flow slows down of the breast and repeat. Think of the or stops. At the beginning this may be just a breast as a clock face, starting with your Expressing milk for your unwell or premature baby , March 2015 Page 3 of 6. Maternity information few minutes but will become less frequent using cold tap water and sterilising tablets). quite quickly. Stop if it becomes We allow pumping equipment one hour in uncomfortable.
8 The sterilising liquid before use. When Ideally, to establish your milk supply, you removing equipment from the solution, need to pump at least 8-10 times in 24 shake off the excess sterilising fluid, and hours, including once at night. This can be rinse out with sterile/cooled boiled water more frequent during the day but you should before use. not leave longer than 6 hours between On Buscot Ward there are only cold water pumping. Rest whenever you get the sterilisers only which are available in the opportunity. Don't be disheartened if you pump room. The pump room is not available only produce a few drops of milk to start between when all cold with - this is quite normal. If you pump water tanks are refilled. frequently, after a few days you will produce more. Mothers with unwell or premature What if I have difficulty Expressing babies can take time to establish a milk milk ? supply. Remember it is common for the amounts of During the first few weeks the amount of milk produced at each session to vary, if by breastmilk you are able to produce daily is day 10 you are Expressing less than 750mls established.
9 your baby may only take small in 24 hours you may need additional help volumes but production needs to be and support to establish your supply or you maximised for the long term supply. Once may feel you need more support regardless you are producing 750mls a day you can of the amount expressed. Temporary slow down as it is unlikely your baby will reduction in milk supply often coincides with need that amount for some time. However, set-backs in baby 's progress. Try not to get be careful as you don't want to get over full despondent; it will increase again with and develop problems. regular stimulation. After using the pumps, clean thoroughly 1. Please speak to your baby 's nurse on with hot water and washing-up liquid before Buscot as your first port of call or a re-sterilising. member of staff from the postnatal ward. You can also ask to speak to one of the Sterilising equipment: breastfeeding peer supporters from BFN. Steam sterilisers are located in the ward (Breastfeeding Network) or ask to speak nurseries with instructions for their use.
10 To one of the specialist infant feeding Sterilising takes 9 minutes but you have to advisors, who will either come and see allow time for the contents to cool down you on the ward or on Buscot. before use. 2. You can also seek support by ringing Individual cold water sterilising units are 0118 322 7295 to make an appointment available for your use and can be kept at for the hospital breastfeeding clinic open your bedside. You need to change the any weekday, (except bank holidays). sterilising fluid every 24 hours (made up by between 10am and Expressing milk for your unwell or premature baby , March 2015 Page 4 of 6. Maternity information 3. After discharge there are plenty of 4. milk should never be defrosted in a breastfeeding drop-in groups in the microwave oven. community for support and you can also access the hospital breastfeeding clinic. You can store milk : There are lots of people here to help you so o For four hours, (if baby is premature or please do not worry and make sure you ask unwell ) for six hours (for a term healthy for support.))